Bangkok Post - April 25, 2007

Indeed, the government's decision to issue a compulsory licence for Kaletra has already reaped benefits, and not just for Thailand. Although Abbott pulled registrations for Aluvia - a heat-stable form of Kaletra that does not require refrigeration - and six other new drugs in Thailand, the company did reduce the price of both Kaletra and Aluvia for 45 low- and middle-income countries to $1,000 per-patient per year from $2,200 previously.

Thailand was included in this list of countries, but Abbott singled Thailand out by refusing to register Aluvia here. In essence, the pharmaceutical giant was hoping to placate growing calls for an international boycott while still slapping Thailand for daring to take advantage of a WTO agreement on intellectual property rights. The message to the rest of the world was clear: Issue a compulsory licence, and be punished.

But Thai negotiators should accept no punishment from Abbott for issuing a compulsory licence. And that's what makes Abbott's latest offer unacceptable.

First of all, Abbott will still refuse to register six new drugs in Thailand to protest its use of the compulsory licence. This is punishment enough. If Thai policy-makers accept Abbott's latest price reduction on Aluvia - which has been extended to Brazil, China, India and about 40 other countries with no such penalty - then it will have accepted the drug company's right to sanction the country for following an international agreement accepted by 150 WTO members.

Secondly, if Thailand agrees to drop the compulsory licence, it would be giving up a right guaranteed in the TRIPS agreement, which could set a dangerous precedent for future talks with drug companies.

Thailand should not have to apologise or give up rights guaranteed in international treaties for Abbott to register Aluvia and the six other drugs it withdrew. To the contrary, the Thai government's decision to issue compulsory licences has led to cheaper Aids drug prices around the world.

The issue is all about finding the cheapest drugs available for poor patients. As the Public Health Ministry has repeated again and again, the Thai government is not interested in seeking price reductions for rich patients who can afford to pay $2,200 per year for Kaletra or Aluvia. Policy-makers are simply trying to secure cheap prices only for Aids patients who can't afford the drugs and wouldn't buy them anyway.

If Abbott wants to blame anyone for compulsory licences, it can start pointing the finger at the WTO's 150 member governments, including the United States, which agreed that developing countries should have the right to use them. Indeed, TRIPS is the world's foremost agreement on intellectual property rights. It's unacceptable for Abbott to scold Thailand about intellectual property rights when the government has complied with TRIPS throughout the process. Even World Health Organisation head Margaret Chan said Thailand's compulsory licences were "fully in line with the TRIPS agreement."

If Abbott thinks otherwise, it should ask the US government to file a complaint at the WTO's dispute settlement body. If Abbott doesn't do that, it should not expect Thailand or the rest of the world to follow the company's own guidelines on intellectual property.

Although Thai policy-makers courageously started this discussion on intellectual property rights, now the debate must move beyond the country's borders. The WHO and other international bodies should make it clear where they stand.

If TRIPS is nothing more than empty promises, then it must be reworked. If the majority of trading nations oppose compulsory licensing, then it should be done away with altogether. Or if more conditions must be placed on using compulsory licences, then by all means they should be put in place.

But it's the height of hypocrisy for governments to pass a ground-breaking agreement to expand drug access to poor patients, and then heap vitriol on a country that actually tries to implement the deal.

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